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Summary Report Death 01 03

Summary Report Death 01 03

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Published by: franky_pawan on Feb 07, 2010
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Report on Causes of Death:2001-03, Office of Registrar General, India Page 1
Long-term mortality measurement by cause, gender and geographic area hasbeen the requirement of every country. With this in view, Medical Certification of Causes of Death (MCCD) was introduced in the country by providing statutorybacking under Section 10 of the Registration of Births and Deaths Act, 1969. Despiteits operationalization in almost all the States/UTs, the scheme has been working atdifferent levels of efficiency across the states in terms of coverage, reporting andquality of data. At present, deaths occurring in urban medical institutions are onlybeing covered under the scheme. Owing to these limitations, the cause specificmortality flowing from MCCD is far from satisfactory. The gap was bridged to anextent by the ‘Survey of Causes of Death’ undertaken in sample villages of selectedPrimary Health Centres (PHC) in rural areas. However, the ‘Survey of Causes of Death’ had been merged with the Sample Registration System (SRS) from 1999,thus encompassing both rural and urban areas. Since then, a system of Verbal Autopsy under the domain of SRS has been in operation. In order to effectimprovement in the system, the Office of the Registrar General, India (ORGI) incollaboration with the Centre for Global Health Research (CGHR), University of Toronto has been trying to establish a reliable system to measure the causes of death in the country. This is the Second Report on Causes of Death in the country,following the Maternal Mortality Report which was released in October 2006.
The Special Survey of Deaths (SSD), undertaken in 2001-2003, has beencarried out under the domain of Sample Registration System (SRS), which coveredover 6,645 small areas (sample units) in all the States and Union Territories. Thecauses of death have been determined using an advanced form of Verbal Autopsycalled the “RHIME” or Representative, Re-sampled, Routine Household Interview of Mortality with Medical Evaluation method. The SRS field staff that have been trainedextensively for collection of the symptoms, signs and key circumstances leading todeath using a two-page structured form with a brief narrative in local language, haveundertaken the survey. A random sample of about 5-10% of the units has been re-
Report on Causes of Death:2001-03, Office of Registrar General, India Page 2
surveyed by an independent team to ensure the quality of fieldwork, completenessand accuracy. The assignment of causes of death has been done through a medicalevaluation by two independent trained physicians who have examined the fieldreports using a web-based system developed specifically for the study. The casesresulting into continuing disagreements were referred to a third physician toadjudicate the final ICD-10 code.
Overall non-communicable diseases are the leading causes of death in thecountry, constituting 42% of all deaths. Communicable, maternal,perinatal and nutritional conditions constitute another 38% of deaths.Injuries and ill-defined causes constitute 10% of deaths each. However,majority of ill-defined causes are at older ages (70 or higher years) andmost of ill-defined deaths are likely to be from non-communicablediseases.
In the EAG states and Assam, there is a significantly higher proportion of all deaths due to communicable, maternal, perinatal and nutritionalconditions (50%) vis-à-vis 28% in the Other States. In the case of non-communicable diseases, it is the Other States which have a higher proportion (50%) vis-à-vis the EAG states and Assam (33%). Though thegap of 17% in the category is lower than that of the communicablediseases between the two groups of states, it is still significant. Themortality due to injuries is also more in proportion in Other States.
Rural areas report more deaths due to communicable, maternal, perinataland nutritional conditions (41%). The urban areas have a lower number of deaths from communicable, maternal, perinatal and nutritional conditionsbut a higher proportion from non-communicable diseases (56%). Their proportion is less in rural areas (40%). Injuries constitute about the sameproportion in both rural and urban areas; however, the specific causes of injury vary.
Overall, the leading cause of death is cardiovascular disease (19%),followed by respiratory diseases (namely chronic obstructive pulmonarydisease or COPD, asthma, other respiratory diseases; 9%), diarrhoeal
Report on Causes of Death:2001-03, Office of Registrar General, India Page 3
diseases (8%), perinatal conditions (6.3%), respiratory infections such asacute pneumonia (6.2%), tuberculosis (6%), malignant and other neoplasms (5.7%), senility (5.1% – which is concentrated at ages 70 andhigher), unintentional injuries: other (4.9%), and symptoms, signs and ill-defined conditions (4.8%).
Notable differences by gender are seen in the case of diarrhoeal diseaseswith 10% of female deaths against 7% of male deaths, tuberculosis with5% of female deaths vis-à-vis 7% male deaths, and cardiovascular diseases with 17% female deaths versus 20% male deaths.
 Among children aged 0 to 4 years, the top 10 causes of death are:
 Perinatal conditions (33%),
 Respiratory infections (22%),
 Diarrhoeal diseases (14%),
 Other infectious and parasitic diseases (11%),
 Symptoms, signs and ill-defined conditions (3.4%),
 Unintentional injuries: other (3.2%),
 Nutritional deficiencies (2.8%),
 Malaria (2.7%),
 congenital anomalies (2.7%), and
 Fever of unknown origin (1.5%).
Deaths due to perinatal conditions constitute a higher proportionamong males with vast majority of these deaths concentrated in the firstmonth of life. However, deaths on account of most of the other causes arehigher in proportion among females.
 Among infants, the top 10 causes of death are:
 Perinatal conditions (46%),
 Respiratory infections (22%),
 Diarrhoeal diseases (10%),
 Other infectious and parasitic diseases (8%),
 Congenital anomalies (3.1%),
 Symptoms, signs and ill-defined conditions (3%),
 Nutritional deficiencies (2%),
 Unintentional injuries: other (1.4%),
 Malaria (1.1%), and

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